App – Baga Moeketsi Funeral Catering & Decor

Funeral Plan Application Form

Please complete all sections below. Fields marked * are required. Once submitted, you'll be taken to checkout to complete your sign-up for the selected plan.

1. Policy Holder Details

Full Name & Surname *

SA ID Number * Must be exactly 13 digits

Date of Birth *

Gender *

Cellphone Number *

Email Address

Physical Address *

City / Town *

Province *

Place of Birth *

Nationality *

2. Select Your Plan

Plan *

Number of Members / Price *

3. Beneficiaries (up to 12)

Add the people covered under this policy. At least one beneficiary is required.

4. Declaration I confirm that the information provided above is true and correct to the best of my knowledge. *